Provider Demographics
NPI:1912997552
Name:MORELAND, ERIN MICHELLE (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MICHELLE
Last Name:MORELAND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 113
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IN
Mailing Address - Zip Code:47001-0113
Mailing Address - Country:US
Mailing Address - Phone:773-824-5245
Mailing Address - Fax:
Practice Address - Street 1:3057 W CERMAK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-3548
Practice Address - Country:US
Practice Address - Phone:773-257-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19026633122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist